BLOOMINGTON PEDIATRICS AND ALLERGY LTD
NPI 1053506352
Specialist in Bloomington, IL

Q: What is Bloomington Pediatrics And Allergy Ltd's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since September 10, 2007CLIA 14D0432359 · Waiver

306 SAINT JOSEPH DR, BLOOMINGTON, IL 61701(309) 663-2354(309) 662-8602 Get Directions Write a Review

NPPES record last updated: March 27, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Bloomington Pediatrics And Allergy Ltd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLOOMINGTON PEDIATRICS AND ALLERGY LTD (NPI 1053506352) is a healthcare organization registered as a specialist in Bloomington, Illinois and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through June 30, 2028 and lists Susan Lynne Labounty, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1053506352

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameBLOOMINGTON PEDIATRICS AND ALLERGY LTD

Location Address306 SAINT JOSEPH DRBloomington, IL 61701-3506

Mailing Address306 Saint Joseph DrBloomington, IL 61701-3506 · (309) 663-2354 · Fax (309) 662-8602

Phone(309) 663-2354

Fax(309) 662-8602

Organization SubpartNo

Authorized OfficialSusan Lynne LabountyOffice Manager · (309) 663-2354

Enumeration DateSeptember 10, 2007

Last NPPES UpdateMarch 27, 2009

✔ NPI 1053506352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in IL · 036058820

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

306 SAINT JOSEPH DR, Bloomington, IL 61701

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Other Identifiers 8

Medicaid036090475IL

Medicaid036097491IL

Medicaid036058820IL

Medicaid036060449IL

Medicaid036115725IL

Medicaid036078523IL

Medicaid036075395IL

Medicaid036094964IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0432359

Bloomington Pediatrics, Ltd · Bloomington, IL

Active · expires Jun 30, 2028

CLIA Number14D0432359

Laboratory TypePhysician Office

Certificate Effective DateJuly 1, 2026

Certificate Expiration DateJune 30, 2028

Laboratory DirectorAshley S. Kohaus

Laboratory Phone(309) 662-0504

Laboratory LocationBloomington Pediatrics, Ltd306 St Joseph Dr, Bloomington, IL 61701

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRIAN ALAN EMM M.D.

Specialist